Sandra Lee Bagwell, PHD, FNP
Individual provider Active NPI Family Nurse Practitioner · Red Bluff, CA
NPI 1801830880 · NPPES record last updated May 15, 2014
Key facts
- NPI
- 1801830880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- NPF10050 (CA)
- Practice address
- 21750 Sacramento Ave
Red Bluff, CA 96080-7743 - Phone
- (530) 736-6072
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10050 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| 363069 | CA | MD | Lactation Consultant (Registered Nurse) |
| NPF10050 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Healthcare Associates | Family | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | 363069 | CA | |
| Family Nurse Practitioner | 363LF0000X | NPF10050 | CA | Yes |
Addresses
Primary practice location
21750 Sacramento Ave
Red Bluff, CA 96080-7743
Mailing address
21750 Sacramento Ave
Red Bluff, CA 96080-7743
Phone (530) 736-6072
Other providers in Red Bluff, CA
- Theresa T Asato
- Zoeann Ashton
- Kasey J Atkinson
- Sharon Teresa Atkinson
- Aurora V Barriga OD, a Professional Corporation
- Ettie Bailey
- Sharon Lee Bailey
- Leslie Jeanne Ballard
- Donald Raymond Baltazar
- Ntango Desire Banani
All providers in Red Bluff, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.